<%@ page language="java" contentType="text/html; charset=utf-8"
	pageEncoding="utf-8"%>
<%@ include file="/commons/taglibs.jsp"%>
<!DOCTYPE html>
<html>
<head>
<meta charset="utf-8">
<meta name="viewport" content="width=device-width, initial-scale=1.0">
<meta name="renderer" content="webkit">
<meta http-equiv="Cache-Control" content="no-siteapp" />
<title>会员信息服务</title>
<%@ include file="/commons/static.jsp"%>
<link rel="shortcut icon" href="${ctx }/home/common/img/favicon.png"
	type="image/x-icon">
</head>
<style>
i {
	color: #00a2ca;
}

i {
	padding-right: 5px;
	white-space: nowrap;
}
</style>
</head>

<body>
	<div class="col-lg-8  col-md-12 col-sm-12 col-xs-12 col-lg-offset-2">
		<div class="widget">
			<div class="widget-header">
				<h2 class="text-center">心理问卷</h2>
			</div>
			<div class="widget-body" style="overflow: hidden">
				<div class="col-lg-12 col-sm-12 col-xs-12 ">
					<div class="widget">
						<section name="section1" id="sec1">
							<form class="form-horizontal form-bordered" role="form" id="form"
								action="${ctx }/customer/saveSurveyRepor" method="post">
								<input id="customerId" value="${id }" hidden name="customerId" />
								<input id="id" value="${re.id }" hidden name="id" /> 
								<input id="content" hidden name="contentPsy" />
								<div class="bancgud row">
									<div class="formfont wjdc_top col-lg-12">
										<img src="${ctx }/dep/img/wenjuan.png"> <span class="No">NO.1</span>
										<span class="inform">心理问卷信息</span>
									</div>
									<h4 class="block col-lg-12">
										<i class="fa fa-exclamation-circle" id="t1"></i>1.我很快乐
									</h4>
									<div class="col-lg-12">
										<div class="radio  form-group">
											<label class="col-lg-2"> <input value="1"
												id="group_1_IFreeHappy1_radio" tab="tab_1" t="t1"
												name="group_1_IFreeHappy_radio" type="radio"> <span
												class="text">完全不符合</span></label> <label class="col-lg-2"> <input
												value="2" id="group_1_IFreeHappy2_radio" tab="tab_1" t="t1"
												name="group_1_IFreeHappy_radio" type="radio" class="">
												<span class="text">比较不符合</span></label> <label class="col-lg-2">
												<input value="3" id="group_1_IFreeHappy3_radio" tab="tab_1"
												t="t1" name="group_1_IFreeHappy_radio" type="radio">
												<span class="text">一般</span>
											</label> <label class="col-lg-2"> <input value="4"
												tab="tab_1" t="t1" id="group_1_IFreeHappy4_radio"
												name="group_1_IFreeHappy_radio" type="radio"> <span
												class="text">比较符合</span></label> <label class="col-lg-2"> <input
												value="5" id="group_1_IFreeHappy5_radio" tab="tab_1" t="t1"
												name="group_1_IFreeHappy_radio" type="radio"> <span
												class="text">完全符合</span></label>
										</div>
									</div>
									<h4 class="block col-lg-12">
										<i class="fa fa-exclamation-circle" id="t2"></i>2.我对未来充满希望
									</h4>
									<div class="col-lg-12">
										<div class="radio  form-group">
											<label class="col-lg-2"> <input value="1" tab="tab_1"
												t="t2" id="group_1_IForHope1_radio"
												name="group_1_IForHope_radio" type="radio"> <span
												class="text">完全不符合</span></label> <label class="col-lg-2"> <input
												value="2" tab="tab_1" t="t2" id="group_1_IForHope2_radio"
												name="group_1_IForHope_radio" type="radio" type="radio"
												class=""> <span class="text">比较不符合</span></label> <label
												class="col-lg-2"> <input value="3" tab="tab_1"
												t="t2" id="group_1_IForHope3_radio"
												name="group_1_IForHope_radio" type="radio"> <span
												class="text">一般</span></label> <label class="col-lg-2"> <input
												value="4" tab="tab_1" t="t2" id="group_1_IForHope4_radio"
												name="group_1_IForHope_radio" type="radio"> <span
												class="text">比较符合</span></label> <label class="col-lg-2"> <input
												value="5" tab="tab_1" t="t2" id="group_1_IForHope5_radio"
												name="group_1_IForHope_radio" type="radio"> <span
												class="text">完全符合</span></label>
										</div>
									</div>
									<h4 class="block col-lg-12">
										<i class="fa fa-exclamation-circle" id="t3"></i>3.即使家人或朋友帮助，我也不能摆脱忧伤
									</h4>
									<div class="col-lg-12">
										<div class="radio  form-group">
											<label class="col-lg-2"> <input value="1" tab="tab_1"
												t="t3" id="group_1_distressed1_radio"
												name="group_1_distressed_radio" type="radio"> <span
												class="text">完全不符合</span></label> <label class="col-lg-2"> <input
												value="2" id="group_1_distressed2_radio" tab="tab_1" t="t3"
												name="group_1_distressed_radio" type="radio" type="radio"
												class=""> <span class="text">比较不符合</span></label> <label
												class="col-lg-2"> <input value="3"
												id="group_1_distressed3_radio" tab="tab_1" t="t3"
												name="group_1_distressed_radio" type="radio"> <span
												class="text">一般</span></label> <label class="col-lg-2"> <input
												value="4" id="group_1_distressed4_radio" tab="tab_1" t="t3"
												name="group_1_distressed_radio" type="radio"> <span
												class="text">比较符合</span></label> <label class="col-lg-2"> <input
												value="5" id="group_1_distressed5_radio" tab="tab_1" t="t3"
												name="group_1_distressed_radio" type="radio"> <span
												class="text">完全符合</span></label>
										</div>
									</div>
									<h4 class="block col-lg-12">
										<i class="fa fa-exclamation-circle" id="t4"></i>4.我感觉孤独
									</h4>
									<div class="col-lg-12">
										<div class="radio  form-group">
											<label class="col-lg-2"> <input value="1" tab="tab_1"
												t="t4" id="group_1_lonely1_radio"
												name="group_1_lonely_radio" type="radio"> <span
												class="text">完全不符合</span></label> <label class="col-lg-2"> <input
												value="2" tab="tab_1" t="t4" id="group_1_lonely2_radio"
												name="group_1_lonely_radio" class="" type="radio"/> <span
												class="text">比较不符合</span></label> <label class="col-lg-2"> <input
												value="3" tab="tab_1" t="t4" id="group_1_lonely3_radio"
												name="group_1_lonely_radio" type="radio"> <span
												class="text">一般</span></label> <label class="col-lg-2"> <input
												value="4" tab="tab_1" t="t4" id="group_1_lonely4_radio"
												name="group_1_lonely_radio" type="radio"> <span
												class="text">比较符合</span></label> <label class="col-lg-2"> <input
												value="5" tab="tab_1" t="t4" id="group_1_lonely5_radio"
												name="group_1_lonely_radio" type="radio"> <span
												class="text">完全符合</span></label>
										</div>
									</div>

									<div class="question_43">
										<h4 class="block col-lg-12">
											<i class="fa fa-exclamation-circle" id="t5"></i>5.我经常感觉压抑或沮丧
										</h4>
										<div class="col-lg-12">
											<div class="radio  form-group">
												<label class="col-lg-2"> <input value="1"
													tab="tab_1" t="t5" id="group_1_depress1_radio"
													name="group_1_depress_radio" type="radio"> <span
													class="text">完全不符合</span></label> <label class="col-lg-2">
													<input value="2" tab="tab_1" t="t5"
													id="group_1_depress2_radio" name="group_1_depress_radio"
													type="radio" class=""> <span class="text">比较不符合</span>
												</label> <label class="col-lg-2"> <input value="3"
													tab="tab_1" t="t5" id="group_1_depress3_radio"
													name="group_1_depress_radio" type="radio"> <span
													class="text">一般</span></label> <label class="col-lg-2"> <input
													value="4" tab="tab_1" t="t5" id="group_1_depress4_radio"
													name="group_1_depress_radio" type="radio"> <span
													class="text">比较符合</span></label> <label class="col-lg-2"> <input
													value="5" tab="tab_1" t="t5" id="group_1_depress5_radio"
													name="group_1_depress_radio" type="radio"> <span
													class="text">完全符合</span></label>
											</div>
										</div>
									</div>


									<div id="neverDrink">
										<h4 class="block col-lg-12">
											<i class="fa fa-exclamation-circle" id="t6"></i>6.我容易情绪激动
										</h4>
										<div class="col-lg-12">
											<div class="radio  form-group">
												<label class="col-lg-2"> <input value="1"
													tab="tab_1" t="t6" id="group_1_rage1_radio"
													name="group_1_rage_radio" type="radio"> <span
													class="text">完全不符合</span></label> <label class="col-lg-2">
													<input value="2" tab="tab_1" t="t6"
													id="group_1_rage2_radio" name="group_1_rage_radio"
													type="radio" class="" /> <span class="text">比较不符合</span>
												</label> <label class="col-lg-2"> <input value="3"
													tab="tab_1" t="t6" id="group_1_rage3_radio"
													name="group_1_rage_radio" type="radio"> <span
													class="text">一般</span></label> <label class="col-lg-2"> <input
													value="4" tab="tab_1" t="t6" id="group_1_rage4_radio"
													name="group_1_rage_radio" type="radio"> <span
													class="text">比较符合</span></label> <label class="col-lg-2"> <input
													value="5" tab="tab_1" t="t6" id="group_1_rage5_radio"
													name="group_1_rage_radio" type="radio"> <span
													class="text">完全符合</span></label>
											</div>
										</div>
										<h4 class="block col-lg-12">
											<i class="fa fa-exclamation-circle" id="t7"></i>7.我生活很紧张
										</h4>
										<div class="col-lg-12">
											<div class="radio  form-group">
												<label class="col-lg-2"> <input value="1"
													tab="tab_1" t="t7" id="group_1_strain1_radio"
													name="group_1_strain_radio" type="radio"> <span
													class="text">完全不符合</span></label> <label class="col-lg-2">
													<input value="2" tab="tab_1" t="t7"
													id="group_1_strain2_radio" name="group_1_strain_radio"
													type="radio" class=""> <span class="text">比较不符合</span>
												</label> <label class="col-lg-2"> <input value="3"
													tab="tab_1" t="t7" id="group_1_strain3_radio"
													name="group_1_strain_radio" type="radio"> <span
													class="text">一般</span></label> <label class="col-lg-2"> <input
													value="4" tab="tab_1" t="t7" id="group_1_strain4_radio"
													name="group_1_strain_radio" type="radio"> <span
													class="text">比较符合</span></label> <label class="col-lg-2"> <input
													value="5" tab="tab_1" t="t7" id="group_1_strain5_radio"
													name="group_1_strain_radio" type="radio"> <span
													class="text">完全符合</span></label>
											</div>
										</div>
										<div class="question_46">
											<h4 class="block col-lg-12">
												<i class="fa fa-exclamation-circle" id="t8"></i>8.最近一年，您感觉压力对健康的影响程度有多大？
											</h4>
											<div class="col-lg-12">
												<div class="radio form-group">
													<label class="col-lg-2"> <input value="1"
														tab="tab_1" t="t8" id="group_1_stressForWell1_radio"
														name="group_1_stressForWell_radio" type="radio"> <span
														class="text">很大</span></label> <label class="col-lg-2"> <input
														value="2" tab="tab_1" t="t8"
														id="group_1_stressForWell2_radio"
														name="group_1_stressForWell_radio" type="radio" class="">
														<span class="text">有些</span></label> <label class="col-lg-2">
														<input value="3" tab="tab_1" t="t8"
														id="group_1_stressForWell3_radio"
														name="group_1_stressForWell_radio" type="radio"> <span
														class="text">几乎没有</span>
													</label> <label class="col-lg-2"> <input value="4"
														tab="tab_1" t="t8" id="group_1_stressForWell4_radio"
														name="group_1_stressForWell_radio" type="radio"> <span
														class="text">没有</span></label>
												</div>
											</div>

											<h4 class="block col-lg-12">
												<i class="fa fa-exclamation-circle" id="t9"></i>9.与同龄人相比，您认为您整体的身体健康状况如何？
											</h4>
											<div class="col-lg-12">
												<div class="radio  form-group">
													<label class="col-lg-2"> <input value="1"
														tab="tab_1" t="t9" id="group_1_wellHealthForPeer1_radio"
														name="group_1_wellHealthForPeer_radio" type="radio">
														<span class="text">非常好</span></label> <label class="col-lg-2">
														<input value="2" tab="tab_1" t="t9"
														id="group_1_wellHealthForPeer2_radio"
														name="group_1_wellHealthForPeer_radio" type="radio"
														class=""> <span class="text">很好</span>
													</label> <label class="col-lg-2"> <input value="3"
														tab="tab_1" t="t9" id="group_1_wellHealthForPeer3_radio"
														name="group_1_wellHealthForPeer_radio" type="radio">
														<span class="text">好</span></label> <label class="col-lg-2">
														<input value="4" tab="tab_1" t="t9"
														id="group_1_wellHealthForPeer4_radio"
														name="group_1_wellHealthForPeer_radio" type="radio">
														<span class="text">一般</span>
													</label> <label class="col-lg-2"> <input value="5"
														tab="tab_1" t="t9" id="group_1_wellHealthForPeer5_radio"
														name="group_1_wellHealthForPeer_radio" type="radio">
														<span class="text">差</span></label>
												</div>
											</div>
											<h4 class="block col-lg-12">
												<i class="fa fa-exclamation-circle" id="t10"></i>10.在过去的一年中，您认为您工作和生活中的精神压力大吗？
											</h4>
											<div class="col-lg-12">
												<div class="radio  form-group">
													<label class="col-lg-2"> <input value="1"
														tab="tab_1" t="t10" id="group_1_mentalStressYear1_radio"
														name="group_1_mentalStressYear_radio" type="radio">
														<span class="text">没有压力</span></label> <label class="col-lg-2">
														<input value="2" tab="tab_1" t="t10"
														id="group_1_mentalStressYear2_radio"
														name="group_1_mentalStressYear_radio" type="radio"
														class=""> <span class="text">压力较少</span>
													</label> <label class="col-lg-2"> <input value="3"
														tab="tab_1" t="t10" id="group_1_mentalStressYear3_radio"
														name="group_1_mentalStressYear_radio" type="radio">
														<span class="text">一般</span></label> <label class="col-lg-2">
														<input value="4" tab="tab_1" t="t10"
														id="group_1_mentalStressYear4_radio"
														name="group_1_mentalStressYear_radio" type="radio">
														<span class="text">压力较大</span>
													</label> <label class="col-lg-2"> <input value="5"
														tab="tab_1" t="t10" id="group_1_mentalStressYear5_radio"
														name="group_1_mentalStressYear_radio" type="radio">
														<span class="text">压力极大</span></label>
												</div>
											</div>

											<div class="col-sm-8  col-xs-offset-3 btn-bottm"
												style="padding-top: 25px">
												<button onclick="upData(0)" type="button"
													class="btn  btn-info col-sm-2 col-xs-offset-3">保存</button>
												<button type="button" onclick="history.go(-1);"
													class="btn btn-active col-sm-2 col-xs-offset-3 next-btn">取消</button>
											</div>
										</div>
									</div>
								</div>
							</form>
						</section>
				</div>
			</div>
		</div>
	</div>
</body>
<script src="${ctx}/home/member/surveyRepor.js"></script>
<script type="text/javascript">
	var json = '${result}';
</script>
</html>


